Healthcare Insurance Verification Specialist

Newton-Wellesley Hospital; Newton (MA); On-site; USD 29,000 - 35,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

Robust retirement savings program

Generous paid time off

Tuition assistance and professional发展

Job summary

Newton-Wellesley Hospital in Newton, MA is seeking an Insurance Authorization Specialist to verify coverage, obtain authorizations, and support accurate reimbursement for medical services. This role involves collaboration with patients, healthcare providers, and insurers and does not include direct patient care.

You will review denials, assist with pre-authorizations, and work with billing and coding staff to ensure timely claim submissions.

Qualifications

• High school diploma or equivalent required.
• Associate's degree in Healthcare Management or related field preferred (experience cannot substitute).
• 2-3 years of healthcare insurance billing experience required.

Responsibilities

• Verify insurance coverage for services to confirm policy eligibility.
• Collect and update patient insurance information (policy numbers, dates, authorization details).
• Work with insurers to obtain or clarify authorizations, including pre-approvals and pre-certifications.
• Partner with billing and coding staff to support accurate, timely claim submissions.
• Coordinate prior authorizations for procedures, tests, surgeries, and other services needing approval.
• Review denial-related documentation and collaborate with providers on appeals and resubmission.
• Help patients understand coverage, benefits, and authorization requirements.

Skills

Insurance verification

Claims processing

Reimbursement practices

Attention to detail

Communication skills

Independent work

Education

High school diploma or equivalent

Associate's degree in Healthcare Management or related field preferred

Job description

Newton-Wellesley Hospital in Newton, MA is seeking an Insurance Authorization Specialist to verify coverage, obtain authorizations, and support accurate reimbursement for medical services. This role involves collaboration with patients, healthcare providers, and insurers and does not include direct patient care.

You will review denials, assist with pre-authorizations, and work with billing and coding staff to ensure timely claim submissions.